Abstract
Serum titres of IgA are raised in ankylosing spondylitis and increased titres of antibodies to klebsiella have also been reported. The humoral response was investigated in ankylosing spondylitis and other inflammatory disorders. IgA antibodies to klebsiella pneumoniae K43 were measured in patients with ankylosing spondylitis, Crohn's disease, ulcerative colitis, and rheumatoid arthritis and in controls. Significantly raised median titres of anti-klebsiella IgA, measured as optical density at 405 nm with an enzyme linked immunosorbent assay (ELISA), were seen among the patients with ankylosing spondylitis (0·7), Crohn's disease (0·8), rheumatoid arthritis (0·6), and ulcerative colitis (0·8) compared with controls (0·4). Activity of disease in ankylosing spondylitis and titres of anti-klebsiella IgA were not correlated. In contrast, titres of anti-klebsiella IgM were significantly lower in patients with ankylosing spondylitis and ulcerative colitis.
The increase in the titres of anti-klebsiella IgA may be due to increased permeability of the gut to bacterial antigens, leading to an increased IgA response in the gut mucosa and permitting the release of IgA into the circulation. As the increased antibody titres were seen in Crohn's disease and rheumatoid arthritis as well as in ankylosing spondylitis the response may be non-specific, occurring because of possible underlying inflammatory bowel disease in these conditions.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bjarnason I., Williams P., So A., Zanelli G. D., Levi A. J., Gumpel J. M., Peters T. J., Ansell B. Intestinal permeability and inflammation in rheumatoid arthritis: effects of non-steroidal anti-inflammatory drugs. Lancet. 1984 Nov 24;2(8413):1171–1174. doi: 10.1016/s0140-6736(84)92739-9. [DOI] [PubMed] [Google Scholar]
- Bjarnason I., Zanelli G., Prouse P., Smethurst P., Smith T., Levi S., Gumpel M. J., Levi A. J. Blood and protein loss via small-intestinal inflammation induced by non-steroidal anti-inflammatory drugs. Lancet. 1987 Sep 26;2(8561):711–714. doi: 10.1016/s0140-6736(87)91075-0. [DOI] [PubMed] [Google Scholar]
- Calguneri M., Swinburne L., Shinebaum R., Cooke E. M., Wright V. Secretory IgA: immune defence pattern in ankylosing spondylitis and klebsiella. Ann Rheum Dis. 1981 Dec;40(6):600–604. doi: 10.1136/ard.40.6.600. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cowling P., Ebringer R., Cawdell D., Ishii M., Ebringer A. C-reactive protein, ESR, and klebsiella in ankylosing spondylitis. Ann Rheum Dis. 1980 Feb;39(1):45–49. doi: 10.1136/ard.39.1.45. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Eastmond C. J., Calguner M., Shinebaum R., Cooke E. M., Wright V. A sequential study of the relationship between faecal Klebsiella aerogenes and the common clinical manifestations of ankylosing spondylitis. Ann Rheum Dis. 1982 Feb;41(1):15–20. doi: 10.1136/ard.41.1.15. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ebringer A., Ptaszynska T., Corbett M., Wilson C., Macafee Y., Avakian H., Baron P., James D. C. Antibodies to proteus in rheumatoid arthritis. Lancet. 1985 Aug 10;2(8450):305–307. doi: 10.1016/s0140-6736(85)90352-6. [DOI] [PubMed] [Google Scholar]
- Ebringer R. W., Cawdell D. R., Cowling P., Ebringer A. Sequential studies in ankylosing spondylitis. Association of Klebsiella pneumoniae with active disease. Ann Rheum Dis. 1978 Apr;37(2):146–151. doi: 10.1136/ard.37.2.146. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ebringer R., Cooke D., Cawdell D. R., Cowling P., Ebringer A. Ankylosing spondylitis: klebsiella and HL-A B27. Rheumatol Rehabil. 1977 Aug;16(3):190–196. doi: 10.1093/rheumatology/16.3.190. [DOI] [PubMed] [Google Scholar]
- Hunter T., Harding G. K., Kaprove R. E., Schroeder M. L. Fecal carriage of various Klebsiella and Enterobacter species in patients with active ankylosing spondylitis. Arthritis Rheum. 1981 Jan;24(1):106–108. doi: 10.1002/art.1780240122. [DOI] [PubMed] [Google Scholar]
- Laurent M. R., Panayi G. S. Acute-phase proteins and serum immunoglobulins in ankylosing spondylitis. Ann Rheum Dis. 1983 Oct;42(5):524–528. doi: 10.1136/ard.42.5.524. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Smith M. D., Gibson R. A., Brooks P. M. Abnormal bowel permeability in ankylosing spondylitis and rheumatoid arthritis. J Rheumatol. 1985 Apr;12(2):299–305. [PubMed] [Google Scholar]
- Trull A. K., Panayi G. S. Serum and secretory IgA immune response to Klebsiella pneumoniae in ankylosing spondylitis. Clin Rheumatol. 1983 Dec;2(4):331–337. doi: 10.1007/BF02041551. [DOI] [PubMed] [Google Scholar]
- Trull A., Ebringer A., Panayi G., Ebringer R., James D. C. HLA-B27 and the immune response to enterobacterial antigens in ankylosing spondylitis. Clin Exp Immunol. 1984 Jan;55(1):74–80. [PMC free article] [PubMed] [Google Scholar]
- Warren R. E., Brewerton D. A. Faecal carriage of klebsiella by patients with ankylosing spondylitis and rheumatoid arthritis. Ann Rheum Dis. 1980 Feb;39(1):37–44. doi: 10.1136/ard.39.1.37. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van Bohemen C. G., Nabbe A. J., Goei The H. S., Dekker-Saeys A. J., Zanen H. C. Antibodies to Enterobacteriaceae in ankylosing spondylitis. Scand J Rheumatol. 1986;15(2):143–147. doi: 10.3109/03009748609102080. [DOI] [PubMed] [Google Scholar]